No4(4) 2021
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DOI 10.37219/2528-8253-2021-4-16 |
Zabolotnyi DI, Lutsenko VI, Bieliakova IA, Nechiporenko PV,
Situkho MI,
Kholodenko TYu, Hradiuk NM
Results of Federichi Tuning fork test in different bone-air gap sizes |
Zabolotny Dmitry I
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine.
Director
Doctor of Medical Sciences, Professor, Academician of the National Academy
of Medical Sciences of Ukraine
E-mail: amtc@kndio.kiev.ua
https://www.scopus.com/authid/detail.uri?authorId=6701512931
Orchid ID: https://orcid.org/0000-0002-4848-840X
Lutsenko Viktor I.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Head of Laboratory of Clinical Audiology and Vestibulology
Doctor of Medical Sciences
E-mail: vil1954@ukr.net
ORCID ID: 0000-0001-6517-2223
Scopus Author ID: 57222327855
Belyakova Irina A.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Laboratory of Clinical Audiology and Vestibulology
Leading researcher
PhD
E-mail: irina1954tolay@gmail.com
Nechiporenko Pavlo V.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Laboratory of Clinical Audiology and Vestibulology
Senior Researcher
Candidate of Medical Sciences
E-mail: pvnechip@gmail.com
Situkho M
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Laboratory of Clinical Audiology and Vestibulology
Researcher
email: maxim.situkho@gmail.com
https://orcid.org/0000-0002-9021-4621
Scopus Author ID: 57193791469
Kholodenko Tetiana Yu.
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Scientific Secretary
E-mail: amtc@kndio.kiev.ua
ORCID ID: https://orcid.org/0000-0002-6578-5799
Scopus Author ID: 6506250388
Hradiuk Nataliya
State Institution “Institute of otolaryngology named after Prof. O.S.
Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv,
Ukraine
Laboratory of Clinical Audiology and Vestibulology
Junior Researcher
E-mail: svr_lor@ukr.net
ORCID ID: 0000-0003-1298-6420 |
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Abstract
Background: Tuning fork tests, in particular the Federici test, allow
to some extent verifying the correctness of subjective audiometry. During
the Federici test patients should compare the volume of the tuning fork
placed on the tragus or mastoid process. Federici test is considered
positive if the sound seems louder from the tragus than from the mastoid
process. Federici test is considered negative if the sound of the tuning
fork seems louder from the mastoid process than from the tragus. Literature
data indicate that the results of certain tuning fork tests may be different
if tuning forks are made of different alloys. Publications describing the
characteristics of Federici test at presence different sizes of air-bone gap
(ABG) are extremely limited.
Aim: improving the effectiveness of the hearing loss diagnosis by
clarifying the Federici test value in case of conduction hearing loss.
Materials and methods: We analyzed 50 audiograms with a sizes of ABG
of 10 dB or more at 125 Hz to clarify when the Federici test can be positive
or negative. All tuning fork tests were performed with C128 aluminum tuning
forks. The Federici test method: after activation the tuning fork it is
placed on the mastoid process, then on the tragus. The forms were marked
with the results of the following tuning fork tests: Weber, Federici, Bing;
and the distance of the patient's perception of whispered and spoken
language, the results of audiometric Weber test, pure tone (in the
conventional frequency range) and speech audiometry.
Results and discussion: Among the audiograms with ABG, a positive
Federici test (group I) was observed in 39 cases (57 %), and a negative test
(group II) was observed in 30 cases (43 %). Assessment of hearing loss was
performed according to the criteria by Bazarov VH and Rozkladka AI (1989).
The results of first group: the first degree of hearing loss was registered
in 30 cases (76.9 %), the second degree in 6 cases (15.4 %) and the third
degree in 3 cases (7.7 %). The results of the second group were following:
the first degree of hearing loss was registered in 24 cases (80 %), the
second degree was registered in 2 cases (6.7 %) and the third degree was
registered in 3 cases (13.3 %).
The article contains tables with data of sizes of ABG at different
frequencies in cases of positive and negative Federici tests, as well as the
difference between air and bone conduction in speech audiometry (performing
the test of 50 % numerals discrimination threshold by Kharshak). There are
samples of audiograms for both positive and negative Federici tests with the
same ABG size given.
Conclusions: We studied the characteristics of the Federici test
performed with C128 aluminum tuning forks in patients with different sizes
of bone-air gap at a frequency of 125 Hz. When ABG is from 10 to 35 at a
frequency of 125 Hz, the Federici test can be both positive and negative,
because the result is also affected by size of ABG at frequencies of 250,
500 and 1000 Hz. If Federici test is positive, there is a decrease in a
difference between air and bone conduction when performing speech audiometry
(performing of the test of 50 % numerals discrimination threshold by
Kharshak), and if test is negative there is an increase in the difference.
The Federici test is always negative when size of ABG is 40 dB and more at a
frequency of 125 Hz.
Our results partially different from the literature. In particular, we have
shown that a positive Federici test can be with a maximum size of ABG 35 dB
at a frequency of 125 Hz and clarified in which cases that can be possible.
One of the promising directions of research is the diagnostic value of the
Federici test in different middle ear pathology. |
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Keywords
air-bone gap, conductive hearing loss, Federici test, frequency, tuning fork
test. |
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